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Identifying recommended dietary allowances for protein and amino acids: a critique of the 2007 WHO/FAO/UNU report

  • D. Joe Millward (a1)
Abstract

The WHO/FAO/UNU (2007) report examines dietary protein and amino acid requirements for all age groups, protein requirements during pregnancy, lactation and catch-up growth in children, the implications of these requirements for developing countries and protein quality evaluation. Requirements were defined as the minimum dietary intake which satisfies the metabolic demand and achieves nitrogen equilibrium and maintenance of the body protein mass, plus the needs for growth in children and pregnancy and lactation in healthy women. Insufficient evidence was identified to enable recommendations for specific health outcomes. A meta analysis of nitrogen balance studies identifies protein requirements for adults 10 % higher than previous values with no influence of gender or age, consistent with a subsequently published comprehensive study. A new factorial model for infants and children, validated on the basis of the adequacy of breast milk protein intakes and involving a lower maintenance requirement value, no provision for saltatory growth and new estimates of protein deposition identifies lower protein requirements than in previous reports. Higher values for adult amino acid requirements, derived from a re-evaluation of nitrogen balance studies and new stable isotope studies, identify some cereal-based diets as being inadequate for lysine. The main outstanding issues relate to the biological implausibility of the very low efficiencies of protein utilisation used in the factorial models for protein requirements for all population groups especially pregnancy when requirements may be overestimated. Also considerable uncertainty remains about the design and interpretation of most of the studies used to identify amino acid requirement values.

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Corresponding author
*Corresponding author: D. Joe Millward, email D.Millward@surrey.ac.uk
References
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1Food and Agriculture Organization (1957) Protein requirements Report of the FAO Committee. FAO Nutritional Studies No. 16 Rome: FAO.
2World Health Organization/Food and Agriculture Organization (1965) Protein requirements Report of a Joint FAO/WHO Expert Group, WHO Technical Report Series, No. 301. Geneva: WHO.
3World Health Organization/Food and Agriculture Organization (1973) Energy and protein requirements Report of a Joint FAO/WHO ad hoc Expert Committee. WHO Technical Report Series, No. 522. Geneva: WHO.
4World Health Organization/Food and Agriculture Organization/United Nations University (1985) Energy and protein requirements Report of a Joint FAO/WHO/UNU Expert Consultation. WHO Technical Report Series, No. 724. Geneva: WHO.
5World Health Organization/Food and Agriculture Organization/United Nations University (2007) Protein and Amino Acid Requirements in Human Nutrition Report of a Joint WHO/FAO/UNU Expert Consultation. WHO Technical Report Series no. 935. Geneva: WHO.
6Scrimshaw NS (1976) Shattuck Lecture: strengths and weakness of the committee approach. N Engl J Med 294, 136142.
7Rand WM, Pellett PL & Young VR (2003) Meta-analysis of nitrogen balance studies for estimating protein requirements in healthy adults. Am J Clin Nutr 77, 109127.
8Beaton GH & Chery A (1988) Protein requirements of infants: a re-examination of concepts and approaches. Am J Clin Nutr 48, 14031412.
9Dewey KG, Beaton G, Fjeld C, et al. (1996) Protein requirements of infants and children. E J Clin Nutr 50, S119S147.
10Badaloo A, Boyne M, Reade M, et al. (1999) Dietary protein, growth and urea kinetics in severely malnourished children and during recovery. J Nutr 129, 969979.
11Campbell WW, Johnson CA, McCabe GP, et al. (2008) Dietary protein requirements of younger and older adults. Am J Clin Nutr; 88, 13221329.
12Millward DJ & Roberts SB (1996) Protein requirements of older individuals. Nutr Res Rev 9, 6787.
13Millward DJ (1998) Metabolic Demands for Amino Acids and the Human Dietary Requirement: Millward and Rivers (1988) Revisited. J Nutr 128, 2563S2576S.
14Millward DJ (2001) Methodological issues. Proc Nutr Soc; 60, 35.
15Millward DJ (2004) Macronutrient intakes as determinants of dietary protein and amino acid adequacy. J Nutr 134, 1588S1596S.
16Oddoye EA & Margen S (1979) Nitrogen balance studies in humans: long term effect of high nitrogen intake on nitrogen accretion. J Nutr 109, 363377.
17Young VR, Wayler A, Garza C, et al. (1984) A long-term metabolic balance study in young men to assess the nutritional quality of an isolated soyprotein and beef proteins. Am J Clin Nutr 39, 815.
18Morse MH, Haub MD, Evans WJ, et al. (2001) Protein Requirement of Elderly Women Nitrogen Balance Responses to Three Levels of Protein Intake. Gerontol A Biol Sci Med Sci 56, 11, M724M730.
19Campbell WW, Trappe TA, Jozsi AC, et al. (2002) Dietary protein adequacy and lower body versus whole body resistive training in older humans. J Physiol 542, 631642.
20Atinmo T, Mbofung CM, Hussain MA, et al. (1985) Human protein requirements: obligatory urinary and faecal nitrogen losses and the factorial estimation of protein needs of Nigerian male adults. Br J Nutr 54, 605611.
21Horwitt MK, Harvey CC, Rothwell WS, et al. (1956) Tryptophan-Niacin relationships in man. J Nutr 60, Suppl, 143.
22Young VR, Taylor YSM, Rand WM, et al. (1973) Protein requirements of man: efficiency of egg protein utilization at maintenance and submaintenance levels in young men. J Nutr 103, 11641174.
23Istfan N, Murry E, Janghorbani M, et al. (1983) An evaluation of the nutritional value of a soy protein concentrate in young adult men using the short-term N-balance method. J Nutr 113, 25162523.
24Millward DJ & Rivers J (1988) The nutritional role of indispensible amino acids and the metabolic basis for their requirements. E J Clin Nutr 42, 367393.
25Millward DJ (2003) An adaptive metabolic demand model for protein and amino acid requirements. Br J Nutr 90, 249260.
26Millward DJ & Pacy PJ (1995) Postprandial protein utilisation and protein quality assessment in man. Clin Sci 88, 597606.
27Fouillet H, Bos C, Gaudichon C, et al. (2002) Approaches to quantifying protein metabolism in response to nutrient ingestion. J Nutr 132, 3208S3218S.
28Bos C, Juillet B, Fouillet H, et al. (2005) Postprandial metabolic utilization of wheat protein in humans. Am J Clin Nutr 81, 8794.
29Fouillet H, Juillet B, Gaudichon C, et al. (2009) Absorption kinetics are a key factor regulating postprandial protein metabolism in response to qualitative and quantitative variations in protein intake. Am J Physiol Regul Integr Comp Physiol 297, R1691R1705.
30Fuller MF & Garthwaite O (1993) The Form of Response of Body Protein Accretion to Dietary Amino Acid Supply. J Nutr 123, 957963.
31Millward DJ (1995) A protein-stat mechanism for the regulation of growth and maintenance of the lean-body mass. Nutr Res Revs 8, 93120.
32Merialdi M, Carroli G, Villar J, et al. (2003) Nutritional interventions during pregnancy for the prevention or treatment of impaired fetal growth: an overview of randomized controlled trials. J Nutr 133, 1626S1631S.
33Food and Agriculture Organisiation (2004) Human energy requirements Report of a Joint FAO/WHO/UNU Expert Consultation. Food and nutrition technical report series 1 Rome, FAO.
34Butte NF, Ellis KJ, Wong WW, et al. (2003) Composition of gestational weight gain impacts maternal fat retention and infant birth weight. Am J Obstet Gynecol; 189, 5, 14231432.
35Scientific Advisory Committee on Nutrition (2011) The energy requirements of the UK population. In the press.
36Pineda O, Torun B, Viteri FE, et al. (1981) Protein quality in relation to estimates of essential amino acid requirements. In Protein quality in humans: assessment and in vitro estimation [, editors]. Westport, CT, AVI, 29-42.
37Rose WC (1957) The amino acid requirements of adult man. Nutr Abs Revs 27, 3, 631647.
38Hegsted DM (1963) Variation in requirements of nutrients – amino acids. Fed Proc 22, 14241430.
39Irwin MI & Hegsted DM (1971) A conspectus of research on amino acid requirements of man. J Nutr 101, 539566.
40Millward DJ (2004) Vernon Young and the development of current knowledge in protein and amino acid nutrition: Vernon Young 1937–2004. Br J Nutr 92, 189197.
41Pencharz PB & Ball RO (2003) Different approaches to define individual amino acid requirements. Annu Rev Nutr 23, 101116.
42Millward DJ, Fereday A, Gibson NR, et al. (2000) Human adult protein and amino acid requirements: [13C-1] leucine balance evaluation of the efficiency of utilization and apparent requirements for wheat protein and lysine compared with milk protein in healthy adults. Am J Clin Nutr 72, 112121.
43Millward DJ, Fereday A, Gibson NR, et al. (2002) Efficiency of utilization and apparent requirements for wheat protein and lysine determined by a single meal [13C-1] leucine balance comparison with milk protein in healthy adults. Am J Clin Nutr 76, 13261334.
44Millward DJ (1999) The nutritional value of plant based diets in relation to human amino acid and protein requirements. Proc Nutr Soc 58, 249260.
45Rand WM & Young VR (1999) Statistical analysis of nitrogen balance data with reference to the lysine requirement in adults. J Nutr 129, 19201926.
46Fuller MF & Garlick PJ (1994) Human amino acid requirements: can the controversy be resolved? Ann Rev Nutr 14, 217241.
47Young VR, Bier DM & Pellett PL (1989) A theoretical basis for increasing current estimates of the amino acid requirements in adult man with experimenta support. Am J Clin Nutr 50, 8092.
48Meredith CN, Wen Z-M, Bier DM, et al. (1986) Lysine kinetics at graded lysine intakes in young men. Am J Clin Nutr 43, 787794.
49Millward DJ (1990) Amino acid requirements in adult man. Am J Clin Nutr 51, 492493.
50Millward DJ (1994) Can we define indispensable amino acid requirements and assess protein quality in adults? J Nutr 124, 15091516.
51Millward DJ (1997) Human amino acid requirements. J Nutr 127, 18421846.
52Young VR & El Khoury AE (1995) Can amino acid requirements for nutritional maintenance in adult humans be approximated from the amino acid composition of body mixed proteins? Proc Nat Acad Sci 92, 300304.
53McLarney MJ, Pellet PL & Young VR (1996) Pattern of amino acids in humans: an interspecies comparison using published amino acid requirement recommendations. J Nutr 126, 18711882.
54Bier DM, Matthews DE & Young VR (1985) Interpretation of amino acid kinetic studies in the context of whole-body protein metabolism. In Substrate and Energy Metabolism in Man, pp. 2736 [, editors]. London & Paris: John Libbey.
55Reeds P (2001) The biology of amino acid requirements: what do they mean and can we measure them? Proc Nutr Soc 60, 1314.
56Pillai RJ, Elango R, Muthayya S, et al. (2010) Lysine requirement of healthy, school-aged Indian children determined by the indicator amino acid oxidation technique. J Nutr 140, 5459.
57Elango R, Mohammad A Humayun, et al. (2007) Lysine requirement of healthy school-age children determined by the indicator amino acid oxidation method. Am J Clin Nutr 86, 360365.
58Kriengsinyos W, Linda J Wykes, Ronald O Ball, et al. (2002) Oral and Intravenous Tracer Protocols of the Indicator Amino Acid Oxidation Method Provide the Same Estimate of the Lysine Requirement in Healthy Men. J Nutr 132, 22512257.
59Kurpad AV, Regan MM, Raj T, et al. (2002) Lysine requirements of healthy adult Indian subjects receiving long-term feeding measured with a 24-h indicator amino acid oxidation and balance technique. Am J Clin Nutr 76, 404412.
60Kurpad AV, Regan MM, Raj T, et al. (2003) Lysine requirements of chronically undernourished adult Indian men, measured by a 24-h indicator amino acid oxidation and balance technique. Am J Clin Nutr 77, 101108.
61Kurpad AV, Regan MM, Nazareth D, et al. (2003) Intestinal parasites increase dietary lysine requirement in chronically undernourished adult Indian men. Am J Clin Nutr 78, 11451151.
62Kurpad AV, Meredith M, Regan, et al. (2006) The daily phenylalanine requirement of healthy Indian adults. Am J Clin Nutr 83, 13311336.
63Zello GA, Pencharz PB & Ball RO Dietary lysine requirement of young adult males determined by oxidation of L-[1-13C]phenylalanine Am J Physiol 264, E677E685..
64Wilson DC, Mahroukh Rafii, Ronald O Ball, et al. (2000) Threonine requirement of young men determined by indicator amino acid oxidation with use of L-[1- 13C]phenylalanine. Am J Clin Nutr 71, 757764.
65Lazaris-Brunner G, Rafii M, Ball RO, et al. (1998) Tryptophan requirement in young adult women as determined by indicator amino acid oxidation with L-[13C]phenylalanine. Am J Clin Nutr 68, 303310.
66Millward DJ & Jackson A (2004) Protein:energy ratios of current diets in developed and developing countries compared with a safe protein:energy ratio: implications for recommended protein and amino acid intakes. Pub Health Nutr 7, 387405.
67Young VR, Scrimshaw NS & Pellett PL (1998) Significance of dietary protein source in human nutrition: Animal and/or Plant Proteins? In Feeding a World Population of More than Eight Billion People: A Challenge to Science, pp. 205221 [, editors]. New York: Oxford University Press in association with Rank Prize Funds.
68Bolourchi S, Friedmann CM & Mickelsen O (1968) Wheat flour as a source of protein for human subjects. Am J Clin Nutr 21, 827835.
69Edwards CH, Booker LK, Rumph Ch, et al. (1971) Utilization of wheat by adult man: nitrogen metabolism plasma amino acids and lipids. Am J Clin Nutr 24, 181193.
70Ahenkora K, Twumasi-Afriyie S, Yao P, et al. (1999) Protein nutritional quality and consumer acceptability of tropical Ghanaian quality protein maize. Food Nutr Bull 20, 3, 354360.
71Akalu G, Taffesse S, Gunaratna N, et al. (2010) The effectiveness of quality protein maize in improving the nutritional status of young children in the Ethiopian highlands. Food Nutr Bull 31, 3, 418430.
72Millward DJ & Garnett T (2010) Food and the planet: nutritional dilemmas of greenhouse gas emission reductions through reduced intakes of meat and dairy foods. Proc Nutr Soc 69, 103118.
73Millward DJ (1999) Optimal intakes of dietary protein. Proc Nutr Society 58, 403413.
74Darling AL, Millward DJ, Torgerson DT, et al. (2009) Dietary protein and bone health: a systematic review and meta-analysis. Am J Clin Nutr 90, 16741692.
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